Individual
MRS. DEDRA L SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSW, LICDC
Contact information
Practice address
1791 ALUM CREEK DR, COLUMBUS, OH 43207-1757
(614) 445-8131
Mailing address
1791 ALUM CREEK DR, COLUMBUS, OH 43207-1708
(614) 445-8131
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LICDC.162057
OH
104100000X
Social Worker
Primary
S1000824
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0331999
—
OH
Enumeration date
01/22/2019
Last updated
02/28/2021
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